Immunogenic composition

ABSTRACT

The present invention relates to fusion proteins comprising fragments of toxin A and toxin B from  Clostridium difficile , such as wherein the first fragment and the second fragment are adjacent to one another and wherein the first repeat portion and the second repeat portion have sequence similarity to one another.

This application is filed pursuant to 35 U.S.C. §371 as a United StatesNational Phase Application of International Patent Application SerialNo. PCT/EP2012/059793 filed May 25, 2012, which claims priority to U.S.Patent Application No. 61/490,734 filed May 27, 2011, and U.S. PatentApplication No. 61/490,707 filed May 27, 2011 and U.S. PatentApplication No. 61/490,716 filed May 27, 2011 and the entire contents ofeach of the foregoing applications are hereby incorporated by reference.

TECHNICAL FIELD

The present invention relates to antigens from Clostridium difficile. Inparticular the invention relates to recombinant polypeptides comprisingfragments of toxin A and toxin B from C. difficile. The inventionadditionally relates to immunogenic compositions or vaccines comprisingthese polypeptides, and the use of the vaccines and immunogeniccompositions of the invention in prophylaxis or therapy. The inventionalso relates to methods of immunising using the compositions of theinvention, and the use of the compositions of the invention in themanufacture of a medicament.

BACKGROUND

C. difficile is the most important cause of nosocomial intestinalinfections and is the major cause of pseudomembranous colitis in humans(Bartlett et al Am. J. Clin. Nutr. 11 suppl:2521-6 (1980)). The overallassociated mortality rate for individuals infected with C. difficile wascalculated to be 5.99% within 3 months of diagnosis, with highermortality associated with advanced age, being 13.5% in patients over 80years (karas et al Journal of Infection 561:1-9 (2010)). The currenttreatment for C. difficile infection is the administration ofantibiotics (metronidazole and vancomycin), however there has beenevidence of strains which are resistant to these antibiotics (Shah etal., Expert Rev. Anti Infect. Ther. 8(5), 555-564 (2010)). Accordinglythere is a need for immunogenic compositions capable of inducingantibodies to, and/or a protective immune response to, C. difficile.

BRIEF SUMMARY

The enterotoxicity of C. difficile is primarily due to the action of twotoxins, toxin A and toxin B. These are both potent cytotoxins (Lyerly etal Current Microbiology 21:29-32 (1990). The C-terminal domains of toxinA and toxin B comprise repeating units, for example the C-terminaldomain of toxin A is made up of contiguous repeating units (Dove et alInfect. Immun. 58:480-499 (1990)), for this reason the C-terminal domainmay be referred to as the ‘repeating domain’. These repeat portions canbe separated further into short repeats (SRs) and long repeats (LRs) asdescribed in Ho et al (PNAS 102:18373-18378 (2005)).

The structure of a 127-aa fragment from the C terminus of the toxin Arepeat domain has been determined (Ho et al PNAS 102:18373-18378(2005)). This fragment formed a β-solenoid like fold, composedpredominantly of β strands with a low proportion of α helices.

It has been demonstrated that fragments of toxin A, in particularfragments of the C-terminal domain, can lead to a protective immuneresponse in hamsters (Lyerly et al Current Microbiology 21:29-32(1990)), WO96/12802 and WO000/61762.

There is known to be difficulty involved in designing fusion proteinswhich fold correctly during expression. The polypeptides of the presentinvention are fusion proteins in which the native β solenoid likestructure is maintained, and which are seen to provide an immuneresponse against both toxin A and toxin B in mice.

In a first aspect of the invention there is provided a polypeptidecomprising a first fragment and a second fragment, wherein

-   (i) the first fragment is a toxin A repeating domain fragment;-   (ii) the second fragment is a toxin B repeating domain fragment;-   (iii) the first fragment comprises a first proximal end within a    first repeat portion;-   (iv) the second fragment comprises a second proximal end within a    second repeat portion; and-   wherein the first fragment and the second fragment are adjacent to    one another and wherein the first repeat portion and the second    repeat portion have sequence similarity to one another.

In a second aspect of the invention there is provided a polynucleotideencoding the polypeptide of the invention.

In a third aspect of the invention there is provided a vector comprisingthe polynucleotide of the invention linked to an inducible promoter.

In a fourth aspect of the invention there is provided a host cellcomprising the vector of the invention or the polynucleotide of theinvention.

In a fifth aspect of the invention there is provided an immunogeniccomposition comprising the polypeptide of the invention and apharmaceutically acceptable excipient.

In a sixth aspect of the invention there is provided a vaccinecomprising the immunogenic composition of the invention and apharmaceutically acceptable excipient.

In a seventh aspect of the invention there is provided a use of theimmunogenic composition of the invention or the vaccine of the inventionin the treatment or prevention of C. difficile disease.

In an eighth aspect of the invention there is provided a use of theimmunogenic composition of the invention or the vaccine of the inventionin the preparation of a medicament for the prevention or treatment of C.difficile disease.

In a ninth aspect of the invention there is provided a method ofpreventing or treating C. difficile disease comprising administering theimmunogenic composition of the invention or the vaccine of the inventionto a patient.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1—Sequence listings of polypeptides of the invention.

FIG. 2—Pictorial representation of the C-terminal domains of ToxA andToxB, with the SR repeats depicted as white boxes and the LR boxesdepicted as black boxes.

FIG. 3—Pictorial representation of a junction between the third SR VIIIof ToxA and the fourth SR II of Tox B used in Fusion 1.

FIG. 4—Pictorial representation of a junction between the second SR VIIIof ToxA and the third SR II of Tox B used in Fusion 2.

FIG. 5—Pictorial representation of a junction between LRVII of ToxA andLRII of ToxB used in Fusion 3 (containing only part of LRVII of ToxA andpart of LR II of ToxB).

FIG. 6—Pictorial representation of a junction between the second SR VIIIof ToxA and the third SRI of ToxB used in Fusion 4.

FIG. 7—Pictorial representation of a junction comprising a glycinelinker between the last residue of the ToxA protein sequence and thebeginning of the fourth SRII of ToxB used in Fusion 5.

FIG. 8—Graphs describing the distribution of C. difficile ToxA-ToxBfusions 1-5 as determined by sedimentation velocity analyticalultracentrifugation. Panel a) describes the distribution of Fusion 1,panel b) describes the distribution of Fusion 2, panel c) describes thedistribution of Fusion 3, panel d) describes the distribution of Fusion4 and panel e) describes the distribution of Fusion 5.

FIG. 9—Graph describing the Far-UV spectrum of Fusions, 2, 3, 4, and 5measured using circular dichroism. The spectrum for fusion 2 isrepresented by a line with the points depicted as small squares, thespectrum for fusion 3 is represented by a line with the points depictedas small diamond shapes, fusion 4 is represented by a line with thepoints depicted as circles, and fusion 5 is represented by a line withthe points depicted as cross shapes.

FIG. 10—Graph describing the near-UV spectrum of Fusions 2, 3, 4, and 5measured using circular dichroism. The spectrum for fusion 2 isrepresented by a line with the points depicted as cross shapes, thespectrum for fusion 3 is represented by a line with the points depictedas circles, the spectrum for fusion 4 is represented by a line with thepoints depicted as triangles, and the spectrum for fusion 5 isrepresented by a line with the points depicted as small diamond shapes.

FIG. 11—Graph showing anti-ToxA immunogenicity in mice immunised with afragment of the C-terminus of toxin A (aa 2387-2706), a fragment of theC-terminus of toxin B (aa 1750-2360), or fusions 1, 2, 3, 4 or 5.

FIG. 12—Graph showing hemagglutination inhibition in mice immunised witha fragment of the C-terminus of toxin A (aa 2387-2706), a fragment ofthe C-terminus of toxin B (aa 1750-2360), or fusions 1, 2, 3, 4 or 5.

FIG. 13—Graph showing anti-ToxB immunogenicity in mice immunised with afragment of the C-terminus of toxin A (aa 2387-2706), a fragment of theC-terminus of toxin B (aa 1750-2360), or fusions 1, 2, 3, 4 or 5.

FIG. 14—Cyotoxicity inhibition titres from mice immunised with afragment of the C-terminus of toxin A (aa 2387-2706), a fragment of theC-terminus of toxin B (aa 1750-2360), or fusions 1, 2, 3, 4 or 5.

FIG. 15—Graphs describing the distribution of C. difficile ToxA-ToxBfusions F52New, F54Gly, F54New and F5ToxB as determined by sedimentationvelocity analytical ultracentrifugation. Panel a) describes thedistribution of F52New, panel b) describes the distribution of F54Gly,panel c) describes the distribution of F54New and panel d) describes thedistribution of F5ToxB.

FIG. 16—Graph describing the Far-UV spectrum of fusions F52New, F54Gly,F54New and F5ToxB measured using circular dichroism. The spectrum forF52New is represented by a line with the points depicted as doublecrosses, the spectrum for F54Gly is represented by a line with thepoints depicted as triangles, F54New is represented by a line with thepoints depicted as squares, and F5ToxB is represented by a line with thepoints depicted as cross shapes.

FIG. 17—Graph describing the Near-UV spectrum of fusions F52New, F54Gly,F54New and F5ToxB measured using circular dichroism. The spectrum forF52New is represented by a line with the points depicted as doublecrosses, the spectrum for F54Gly is represented by a line with thepoints depicted as triangles, F54New is represented by a line with thepoints depicted as squares, and F5ToxB is represented by a line with thepoints depicted as cross shapes.

FIG. 18—Graph showing anti-ToxA ELISA results for mice immunised withthe F2, F52New, F54Gly, G54New or F5ToxB fusions.

FIG. 19—Graph showing anti-ToxB ELISA results for mice immunised withthe F2, F52New, F54Gly, F54New or F5ToxB fusions.

FIG. 20—Graph showing hemagglutination inhibition in mice immunised withthe F2, F52New, F54Gly, F54New or F5ToxB fusions.

FIG. 21—Graph showing cytotoxicity titres in HT29 cells from miceimmunised with the F2, F52New, F54Gly, F54New or F5ToxB fusions.

FIG. 22—Graph showing cytotoxicity titres in IMR90 cells from miceimmunised with the F2, F52New, F54Gly, F54New or F5ToxB fusions.

DETAILED DESCRIPTION Polypeptides

The invention relates to a polypeptide comprising a first fragment and asecond fragment, wherein

-   (i) the first fragment is a toxin A repeating domain fragment;-   (ii) the second fragment is a toxin B repeating domain fragment;-   (iii) the first fragment comprises a first proximal end within a    first repeat portion;-   (iv) the second fragment comprises a second proximal end within a    second repeat portion; and-   wherein the first fragment and the second fragment are adjacent to    one another and wherein the first repeat portion and the second    repeat portion have sequence similarity to one another.

The term polypeptide refers to a contiguous sequence of amino acids.

The term ‘toxin A repeating domain’ refers to the C-terminal domain ofthe toxin A protein from C. difficile, comprising repeated sequences.This domain refers to amino acids 1832-2710 of toxin A from strainVPI10463 (ATCC43255) and their equivalents in a different strain, thesequence of amino acids 1832-2710 from strain VPI10463 (ATCC43255)corresponds to amino acids 1832-2710 of SEQ ID NO:1.

The term ‘toxin B repeating domain’ refers to the C-terminal domain ofthe toxin B protein from C. difficile. This domain refers to amino acids1834-2366 from strain VPI10463 (ATCC43255) and their equivalents in adifferent strain, the sequence of amino acids 1834-2366 from strainVPI10463 (ATCC43255) corresponds to amino acids 1834-2366 of SEQ IDNO:2.

The C. difficile toxins A and B are conserved proteins, however thesequence differs a small amount between strains, moreover the amino acidsequence for toxins A and B in different strains may differ in number ofamino acids.

The invention therefore contemplates the term toxin A repeating domainand/or toxin B repeating domain to refer to a sequence which is avariant with 90%, 95%, 98%, 99% or 100% sequence identity to amino acids1832-2710 of SEQ ID NO:1 or a variant with 90%, 95%, 98%, 99% or 100%sequence identity to amino acids 1834-2366 of SEQ ID NO:2. In oneembodiment a ‘variant’ is a polypeptide that varies from the referentpolypeptides by conservative amino acid substitutions, whereby a residueis substituted by another with the same physico-chemical properties.Typically such substitutions are among Ala, Val, Leu and IIe; among Serand Thr; among the acidic residues Asp and Glu; among Asn and Gln, andamong the basic residues Lys and Arg; or aromatic residues Phe and Tyr.In one embodiment a ‘fragment’ is a polypeptide which comprises acontiguous portion of at least 250 amino acids of a polypeptide.

Furthermore the amino acid numbering may differ between the C-terminaldomains of toxin A (or toxin B) from one strain and toxin A (or toxin B)from another strain. For this reason the term ‘equivalents in adifferent strain’ refers to amino acids which correspond those of areference strain (e.g., C. difficile VPI10463), but which are found in atoxin from a different strain and which may thus be numbereddifferently. A region of ‘equivalent’ amino acids may be determined byaligning the sequences of the toxins from the different strains. Theamino acids numbers provided throughout refer to those of strainVPI10463.

The term ‘fragment’ of a polypeptide or protein refers to a contiguousportion of at least 200, 230, 250, 300, 350, 380, 400, 450, 480, 500,530, 550, 580 or 600 amino acids from that polypeptide or protein. Theterm ‘first fragment’ refers to a contiguous portion of at least 250,300, 350, 380, 400, 450, 480, 500, 530, 550, 580 or 600 amino acids ofthe toxin A repeating domain. The term ‘second fragment’ refers to acontiguous portion of at least 200, 230, 250, 280, 300, 350, 400, 450 or500 amino acids of the toxin B repeating domain.

The term ‘first proximal end’ refers to the end of the first fragment(Tox A fragment) which is covalently linked to the second fragment (ToxBfragment) or covalently linked to a linker sequence between the firstand second fragment. The term ‘second proximal end’ refers to the end ofthe second fragment which is closest to the first fragment in primarystructure (amino acid sequence).

FIG. 2 depicts the organisation of the C-terminal domains of ToxA andToxB. The C-terminal domain of toxin A is made up of 8 repeat portions(designated repeat portion I, repeat portion II, repeat portion III,repeat portion IV, repeat portion V, repeat portion VI, repeat portionVII and repeat portion VIII) each of these repeat portions can befurther divided into short repeats (SRs) which are depicted as whiteboxes in FIG. 2 and long repeats (LRs) which are depicted as black boxesin FIG. 2 (except for Tox A repeat portion VIII which does not have along repeat). Each of the long repeats has some structural and sequencesimilarity to the other long repeats. Similarly the short repeats havesome sequence and structural similarity to one another. Similarly theC-terminal domain of toxin B is made up of 5 repeat portions subdividedinto SRs and LRs. Each repeat portion contains one LR and between 2 and5 SRs (except for Tox B repeat portion V which does not have a longrepeat). For the purposes of the disclosure the phrase ‘a repeatportion’ refers to one of the eight repeat portions of ToxA (designatedI, II, III, IV, V, VI, VII and VIII.) or one of the five repeat portionsof ToxB (designated I, II, III, IV or V As used herein the term ‘firstrepeat portion’ refers to a repeat portion (or partial repeat portion)from the toxin A repeating domain. The term ‘second repeat portion’refers to a repeat portion (or partial repeat portion) from the toxin Brepeating domain. For the purposes of the disclosure the term ‘longrepeat’ refers to one of the LR domains depicted as black boxes in FIG.2. For the purposes of the disclosure the term ‘short repeat’ refers toone of the SR domains depicted as white boxes in FIG. 2.

Thus for example, repeat portion I of ToxA contains three SRs and oneLR, which can be referred to as the first SRI of ToxA, the second SRI ofToxA, the third SRI of ToxA and the LRI of ToxA, respectively.

The first proximal end is considered to be within a ‘repeat portion’ ifthe first fragment ends in an amino acid that is within that repeatportion (i.e., the first proximal end contains only part of the repeatportion sequence). Similarly the second proximal end is considered to bewithin a ‘repeat portion’ if the second fragment ends in an amino acidthat is within that repeat portion. For example the first proximal endis within ‘repeat portion I of ToxA if the first fragment ends with anyone of amino acids 1832-1924 (inclusive) of VPI10463 or their equivalentin another strain. The first proximal end is within a ‘long repeat’ or a‘short repeat’ if the first fragment ends in an amino acid that iswithin a ‘long repeat’ or a ‘short repeat’, similarly the secondproximal end is within a ‘long repeat’ or a ‘short repeat’ if the secondfragment ends in an amino acid that is within a ‘long repeat’ or a‘short repeat’.

The amino acid positions of each domain has been defined for toxin A andtoxin B from strain VPI10463 (ATCC43255). These are as follows

TABLE 1 Start End Name position position ToxA_I SR1 1832 1852 SR2 18531873 SR3 1874 1893 LR 1894 1924 ToxA_II SR1 1925 1944 SR2 1945 1965 SR31966 1986 SR4 1987 2007 SR5 2008 2027 LR 2028 2058 ToxA_III SR1 20592078 SR2 2079 2099 SR3 2100 2120 SR4 2121 2141 SR5 2142 2161 LR 21622192 ToxA_IV SR1 2193 2212 SR2 2213 2233 SR3 2234 2253 SR4 2254 2275 LR2276 2306 ToxA_V SR1 2307 2326 SR2 2327 2347 SR3 2348 2368 SR4 2369 2389SR5 2390 2409 LR 2410 2440 ToxA_VI SR1 2441 2460 SR2 2461 2481 SR3 24822502 SR4 2503 2522 LR 2523 2553 ToxA_VII SR1 2554 2573 SR2 2574 2594 SR32595 2613 LR 2614 2644 ToxA_VIII SR1 2645 2664 SR2 2665 2686 SR3 26872710 ToxB_I SR1 1834 1854 SR2 1855 1876 SR3 1877 1896 LR 1897 1926ToxB_II SR1 1927 1946 SR2 1947 1967 SR3 1968 1987 SR4 1988 2007 SR5 20082027 LR 2028 2057 ToxB_III SR1 2058 2078 SR2 2079 2099 SR3 2100 2119 SR42120 2139 SR5 2140 2159 LR 2160 2189 ToxB_IV SR1 2190 2212 SR2 2213 2233SR3 2234 2253 SR4 2254 2273 SR5 2274 2293 LR 2294 2323 ToxB_V SR1 23242343 SR2 2344 2366

For this reason the term ‘repeat portion’ may refer to amino acids1832-1924, 1925-2058, 2059-2192, 2193-2306, 2307-2440, 2441-2553,2554-2644 or 2645-2710 of toxin A (SEQ ID NO:1), or amino acids1834-1926, 1927-2057, 2058-2189, 2190-2323 or 2324-2366 of toxin B (SEQID NO:2) or their equivalents in a different strain of C. difficile.

For this reason the term ‘short repeat’ may refer to amino acids1832-1852, 1853-1873, 1874-1893, 1925-1944 1945-1965, 1966-1986,1987-2007, 2008-2027, 2059-2078, 2079-2099, 2100-2120, 2121-2141,2142-2161, 2193-2212, 2213-2233, 2234-2253, 2254-2275, 2307-2326,2327-2347, 2348-2368, 2369-2389, 2390-2409, 2441-2460, 2461-2481,2482-2502, 2503-2522, 2554-2573, 2574-2594, 2595-2613, 2645-2664,2665-2686 or 2687-2710 of toxin A (SEQ ID NO:1) or amino acids1834-1854, 1855-1876, 1877-1896, 1927-1946, 1947-1967, 1968-1987,1988-2007, 2008-2027, 2058-2078, 2079-2099, 2100-2119, 2120-2139,2140-2159, 2190-2212, 2213-2233, 2234-2253, 2254-2273, 2274-2293,2324-2343 or 2344-2366 of toxin B (SEQ ID NO:2) or their equivalents ina different strain of C. difficile.

Similarly the term ‘long repeat’ may refer to amino acids 1894-1924,2028-2058, 2162-2192, 2276-2306, 2410-2440, 2523-2553 or 2614-2644 oftoxin A (SEQ ID NO:1) or amino acids 1897-1926, 2028-2057, 2160-2189 or2294-2323 of toxin B (SEQ ID NO:2) or their equivalents in a differentstrain of C. difficile.

The polypeptides of the invention may be part of a larger protein suchas a precursor or a fusion protein. It is often advantageous to includean additional amino acid sequence which contains sequences which aid inpurification such as multiple histidine residues, or an additionalsequence for stability during recombinant production. Furthermore,addition of exogenous polypeptide or lipid tail or polynucleotidesequences to increase the immunogenic potential of the final molecule isalso considered.

The word ‘adjacent’ means separated by less than or exactly 20, 15, 10,8, 5, 2, 1 or 0 amino acids in the primary structure.

The fragments may be positioned such that the N-terminus of the firstfragment is adjacent to the C-terminus of the second fragment,alternatively the C-terminus of the first fragment may be adjacent tothe N-terminus of the second fragment, or the C-terminus of the firstfragment may be adjacent to the C-terminus of the second fragment, orthe N-terminus of the first fragment may be adjacent to the N-terminusof the second fragment.

Two sequences will have ‘sequence similarity to one another’ if theyhave greater than 50%, 70%, 75%, 80%, 85%, 90%, 95%, 98%, 99 or 100%sequence identity.

The term ‘identity’ is known in the art, is a relationship between twoor more polypeptide sequences or two or more polynucleotide sequences,as the case may be, as determined by comparing the sequences. In theart, “identity” also means the degree of sequence relatedness betweenpolypeptide or polynucleotide sequences, as the case may be, asdetermined by the match between strings of such sequences. “Identity”can be readily calculated by known methods, including but not limited tothose described in (Computational Molecular Biology, Lesk, A. M., ed.,Oxford University Press, New York, 1988; Biocomputing: Informatics andGenome Projects, Smith, D. W., ed., Academic Press, New York, 1993;Computer Analysis of Sequence Data, Part I, Griffin, A. M., and Griffin,H. G., eds., Humana Press, New Jersey, 1994; Sequence Analysis inMolecular Biology, von Heine, G., Academic Press, 1987; and SequenceAnalysis Primer, Gribskov, M. and Devereux, J., eds., M Stockton Press,New York, 1991; and Carillo, H., and Lipman, D., SIAM J. Applied Math.,48: 1073 (1988). Methods to determine identity are designed to give thelargest match between the sequences tested. Moreover, methods todetermine identity are codified in publicly available computer programs.Computer program methods to determine identity between two sequencesinclude, but are not limited to, the Needle program BLASTP, BLASTN(Altschul, S. F. et al., J. Molec. Biol. 215: 403-410 (1990), and FASTA(Pearson and Lipman Proc. Natl. Acad. Sci. USA 85; 2444-2448 (1988). TheBLAST family of programs is publicly available from NCBI and othersources (BLAST Manual, Altschul, S., et al., NCBI NLM NIH Bethesda, Md.20894; Altschul, S., et al., J. Mol. Biol. 215: 403-410 (1990). The wellknown Smith Waterman algorithm may also be used to determine identity.

Parameters for polypeptide sequence comparison include the following:

-   Algorithm: Needleman and Wunsch, J. Mol Biol. 48: 443-453 (1970)-   Comparison matrix: BLOSSUM62 from Henikoff and Henikoff,-   Proc. Natl. Acad. Sci. USA. 89:10915-10919 (1992)-   Gap Penalty: 10-   Gap extension penalty: 0.5

A program useful with these parameters is publicly available as the‘needle’ program from EMBOSS package (Rice P et al, Trends in Genetics2000 col. 16(6):276-277). The aforementioned parameters are the defaultparameters for peptide comparisons (along with no penalty for end gaps).

In one embodiment the first repeat portion and the second repeat portionhave high structural similarity to one another. Two sequences can beconsidered to have high structural similarity when their percentageidentity is higher than 40%, 45%, 50% or 60% (M. Marty-Renom et al.Annu. Rev. Biophys. Biomol Struct. 2000 vol. 29:291-325). The presenceof high structural similarity can be determined by comparing the twosequences using the SwissModel and SwissPDB Viewer softwares.

In one embodiment the polypeptide of the invention elicits antibodiesthat neutralise toxin A or toxin B. In a further embodiment thepolypeptide elicits antibodies that neutralise toxin A. In a furtherembodiment the polypeptide elicits antibodies that neutralise toxin B.In a further embodiment the polypeptide elicits antibodies thatneutralise toxin A and toxin B. The phrase ‘elicits neutralisingantibodies’ means that the when the compositions are used to immunise amammal for example a mouse, a guinea pig or a human, the mammalgenerates neutralising antibodies.

Whether a polypeptide elicits neutralizing antibodies against a toxincan be measured by immunising mice with an immunogenic compositioncomprising the polypeptide, collecting sera and analysing the anti-toxintitres of the sera using by ELISA. The sera should be compared to areference sample obtained from mice which have not been immunised. Anexample of this technique can be found in example 6. The polypeptide ofthe invention elicits antibodies that neutralise toxin A if the seraagainst the polypeptide gives an ELISA readout more than 10%, 20%, 30%,50%, 70%, 80%, 90% or 100% higher than the reference sample.

In a further embodiment the polypeptide of the invention elicits aprotective immune response in a mammalian host against strains of C.difficile. The phrase ‘elicit a protective immune response’ means thatwhen the immunogenic composition of the invention is used to immunise amammal such as a mouse, guinea pig or human, the mammal generatesantibodies capable of protecting the mammal from death caused by C.difficile. In one embodiment the mammalian host is selected from thegroup consisting of mouse, rabbit, guinea pig, monkey, non-human primateor human. In one embodiment the mammalian host is a mouse. In a furtherembodiment the mammalian host is a human.

Whether a polypeptide elicits a protective immune response in amammalian host against strains of C. difficile can be determined using achallenge assay. In such an assay the mammalian host is vaccinated withthe polypeptide and challenged by exposure to C. difficile, the timewhich the mammal survives after challenge is compared with the timewhich a reference mammal that has not been immunised with thepolypeptide survives. A polypeptide elicits a protective immune responseif a mammal immunised with the polypeptide survives at least 10%, 20%,30%, 50%, 70%, 80%, 90%, or 100% longer than a reference mammal whichhas not been immunised after challenge with C. difficile. In oneembodiment the polypeptide of the invention elicits a protective immuneresponse against strains of C. difficile in a mammal selected from thegroup consisting of mouse, guinea pig, monkey or human. In oneembodiment the mammal is a mouse, in a further embodiment the mammal isa human.

The native structure of the C-terminal (repeat) domains from toxins Aand B consist of an extended β solenoid-like structure. This structureconsists of primarily β sheet structures, with a minority of a helicalstructures as seen in Ho et al (PNAS 102:18373-18378 (2005)). Thesecondary structures present can be determined using circular dichroism.For example measuring the shape and the magnitude of the CD spectra inthe far-UV region (190-250 nm) and comparing the results with those ofknown structures. This can be carried out using an optical path of 0.01cm from 178 to 250 nm, with a 1 nm resolution and bandwidth on a JascoJ-720 spectropolarimeter, for example as seen in example 5 below.

In one embodiment the first fragment comprises less than 28%, 25%, 23%,20%, 18%, 15%, 10%, or 7% alpha helical secondary structure. In oneembodiment the second fragment comprises less than 28%, 25%, 23%, 20%,18%, 15%, 10%, or 7% alpha helical secondary structure. In a furtherembodiment both the first fragment and the second fragment comprise lessthan 28%, 25%, 23%, 20%, 18%, 15%, 10%, or 7% alpha helical secondarystructure.

In one embodiment the first fragment comprises more than 20%, 25%, 28%,30%, 33%, 35%, 38%, 40%, or 42% beta sheet structure. In one embodimentthe second fragment comprises more than 20%, 25%, 28%, 30%, 33%, 35%,38%, 40%, or 42% beta sheet structure. In a further embodiment both thefirst fragment and the second fragment comprises more than 20%, 25%,28%, 30%, 33%, 35%, 38%, 40%, or 42% beta sheet structure.

In one embodiment the first proximal end is within repeat portion V(amino acids 2307-2440 of SEQ ID NO:1 or their equivalent in a differentstrain), VI (amino acids 2441-2553 of SEQ ID NO:1 or their equivalent ina different strain), VII (amino acids 2554-2644 of SEQ ID NO:1 or theirequivalent in a different strain) or VIII (amino acids 2645-2710 of SEQID NO:1 or their equivalent in a different strain) of toxin A. In afurther embodiment the first proximal end is within repeat portion VII(amino acids 2554-2644 of SEQ ID NO:1 or their equivalent in a differentstrain) of toxin A. In a further embodiment the first proximal end iswithin repeat portion VIII (amino acids 2645-2710 of SEQ ID NO:1 ortheir equivalent in a different strain) of toxin A.

In one embodiment the second proximal end is within repeat portion I(amino acids 1834-1926 of SEQ ID NO:2 or their equivalent in a differentstrain), II (amino acids 1927-2057 of SEQ ID NO:2 or their equivalent ina different strain), or III (amino acids 2058-2189 of SEQ ID NO:2 ortheir equivalent in a different strain) of toxin B. In a furtherembodiment the second proximal end is within repeat portion II (aminoacids 1927-2057 of SEQ ID NO:2 or their equivalent in a differentstrain) of toxin B. In a further embodiment the second proximal end iswithin repeat portion I (amino acids 1834-1926 of SEQ ID NO:2 or theirequivalent in a different strain) of toxin B.

In one embodiment the first proximal end is within a long repeat. Thefirst proximal end may be within long repeat V of toxin A (amino acids2410-2440 of SEQ ID NO:1 or their equivalent in a different strain), orwithin long repeat VI of toxin A (amino acids 2523-2553 of SEQ ID NO:1or their equivalent in a different strain), or within long repeat VII oftoxin A (amino acids 2614-2644 of SEQ ID NO:1 or their equivalent in adifferent strain).

In one embodiment the second proximal end is within a long repeat. Thesecond proximal end may be within long repeat I of toxin B (amino acids1897-1926 of SEQ ID NO:2 or their equivalent in a different strain), orwithin long repeat II of toxin B (amino acids 2028-2057 of SEQ ID NO:2or their equivalent in a different strain), or within long repeat III oftoxin B (amino acids 2160-2189 of SEQ ID NO:2 or their equivalent in adifferent strain).

In a further embodiment the first proximal end and the second proximalend are both within long repeats. In one embodiment the first proximalend is within long repeat V of toxin A (amino acids 2410-2440 of SEQ IDNO:1 or their equivalent in a different strain), or within long repeatVI of toxin A (amino acids 2523-2553 of SEQ ID NO:1 or their equivalentin a different strain), or within long repeat VII of toxin A (aminoacids 2614-2644 of SEQ ID NO:1 or their equivalent in a differentstrain) and the second proximal end is within long repeat I of toxin B(amino acids 1897-1926 of SEQ ID NO:2 or their equivalent in a differentstrain), or within long repeat II of toxin B (amino acids 2028-2057 ofSEQ ID NO:2 or their equivalent in a different strain), or within longrepeat III of toxin B (amino acids 2160-2189 of SEQ ID NO:2 or theirequivalent in a different strain). In one embodiment the first proximalend is within long repeat VII of toxin A (amino acids 2614-2644 of SEQID NO:1 or their equivalent in a different strain) and the secondproximal end is within long repeat II of toxin B (amino acids 2028-2057of SEQ ID NO:2 or their equivalent in a different strain).

In one embodiment the first proximal end is within amino acids 2620-2660of toxin A. In one embodiment the second proximal end is within aminoacids 2030-2050 of toxin B. In a further embodiment the first proximalend is within amino acids 2620-2660 of toxin A and the second proximalend is within amino acids 2030-2050 of toxin B.

In one embodiment the first fragment comprises at least 100, 150, 180,200, 240, 250, 280, 300, 330, 350, 380, 400, 430, 450, 480, 500 or 530amino acids. In one embodiment the second fragment comprises at least100, 130, 150, 180, 200, 230, 250, 270, 300, 330, 350, 390, or 400 aminoacids.

In one embodiment the polypeptide further comprises a linker. Thislinker may be between the first proximal end and the second proximalend, alternatively the linker may link the distal ends of the firstfragment and/or the second fragment to a further sequence of aminoacids.

A peptide linker sequence may be employed to separate the first fragmentand second fragment. Such a peptide linker sequence is incorporated intothe fusion protein using standard techniques well known in the art.Suitable peptide linker sequences may be chosen based on the followingfactors: (1) their ability to adopt a flexible extended conformation;(2) their inability to adopt a secondary structure that could interactwith functional epitopes on the first fragment and/or the secondfragments; and (3) the lack of hydrophobic or charged residues thatmight react with the Tox A and/or ToxB functional epitopes. Peptidelinker sequences may contain Gly, Asn and Ser residues. Other nearneutral amino acids, such as Thr and Ala may also be used in the linkersequence. Amino acid sequences which may be usefully employed as linkersinclude those disclosed in Maratea et al., Gene 40:39-46 (1985); Murphyet al., Proc. Natl. Acad. Sci. USA 83:8258-8262 (1986); U.S. Pat. No.4,935,233 and U.S. Pat. No. 4,751,180. The linker sequence may generallybe from 1 to about 50 amino acids in length.

In one embodiment the linker comprises between 1-20, 1-15, 1-10, 1-5,1-2, 5-20, 5-15, 5-15, 10-20, or 10-15 amino acids. In one embodimentthe linker is a glycine linker, the linker may comprise multiplecontiguous glycine residues (1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13,14, 15, 17, or 20), or alternatively the linker may comprise someglycine residues and some residues of other amino acids such as alanine.In a further embodiment the linker comprises a single glycine residue.

In an embodiment the polypeptide of the invention is part of a largerfusion protein. The fusion proteins may further comprise amino acidsencoding an immunogenic portion of a further protein antigen. Forexample the fusion protein may further comprise an immunogenic portionof a protein antigen obtained or derived from a bacterium selected fromthe group consisting of S. pneumoniae, H. influenzae, N. meningitidis,E. coli, M. cattarhalis, C. tentanii, C. diphtheriae, B. pertussis, S.epidermidis, enterococci, S. aureus, and Pseudomonas aeruginosa. In thiscase the linker may be between the first fragment or the second fragmentand a further immunogenic portion of a protein antigen.

The term “immunogenic portion thereof” or ‘immunogenic fragment’ refersto a fragment of a polypeptide wherein the fragment comprises an epitopethat is recognized by cytotoxic T lymphocytes, helper T lymphocytes or Bcells. Suitably, the immunogenic portion will comprise at least 30%,suitably at least 50%, especially at least 75% and in particular atleast 90% (e.g. 95% or 98%) of the amino acids in the referencesequence. The immunogenic portion will suitably comprise all of theepitope regions of the reference sequence.

Polynucleotides

The invention further provides a polynucleotide encoding the polypeptideof the invention. For the purposes of the invention the term‘polynucleotide(s)’ generally refers to any polyribonucleotide orpolydeoxyribonucleotide, which may be unmodified RNA or DNA or modifiedRNA or DNA including single and double-stranded regions/forms.

The term “polynucleotide encoding a peptide” as used herein encompassespolynucleotides that include a sequence encoding a peptide orpolypeptide of the invention. The term also encompasses polynucleotidesthat include a single continuous region or discontinuous regionsencoding the peptide or polypeptide (for example, polynucleotidesinterrupted by integrated phage, an integrated insertion sequence, anintegrated vector sequence, an integrated transposon sequence, or due toRNA editing or genomic DNA reorganization) together with additionalregions, that also may contain coding and/or non-coding sequences.

It will be appreciated by those of ordinary skill in the art that, as aresult of the degeneracy of the genetic code, there are many nucleotidesequences that encode a polypeptide as described herein. Some of thesepolynucleotides bear minimal homology to the nucleotide sequence of anynative (i.e. naturally occurring) gene. Nonetheless, polynucleotidesthat vary due to differences in codon usage are specificallycontemplated by the present invention, for example polynucleotides thatare optimized for human and/or primate and/or e. coli codon selection.

Sequences encoding a desired polypeptide may be synthesized, in whole orin part, using chemical methods well known in the art (see Caruthers, M.H. et al., Nucl. Acids Res. Symp. Ser. pp. 215-223 (1980), Horn et al.,Nucl. Acids Res. Symp. Ser. pp. 225-232 (1980)). Alternatively, theprotein itself may be produced using chemical methods to synthesize theamino acid sequence of a polypeptide, or a portion thereof. For example,peptide synthesis can be performed using various solid-phase techniques(Roberge et al., Science 269:202-204 (1995)) and automated synthesis maybe achieved, for example, using the ASI 431 A Peptide Synthesizer(Perkin Elmer, Palo Alto, Calif.).

Moreover, the polynucleotide sequences of the present invention can beengineered using methods generally known in the art in order to alterpolypeptide encoding sequences for a variety of reasons, including butnot limited to, alterations which modify the cloning, processing, and/orexpression of the gene product. For example, DNA shuffling by randomfragmentation and PCR reassembly of gene fragments and syntheticoligonucleotides may be used to engineer the nucleotide sequences. Inaddition, site-directed mutagenesis may be used to insert newrestriction sites, alter glycosylation patterns, change codonpreference, produce splice variants, or introduce mutations, and soforth.

Vectors

In a further aspect of the invention the present invention relatesvector optionally comprising a polynucleotide of the invention linked toan inducible promoter such that when the promoter is induced apolypeptide encoded by the polynucleotide is expressed.

A further aspect of the invention comprises said vector wherein theinducible promoter is activated by addition of a sufficient quantity ofIPTG (Isopropyl β-D-1-thiogalactopyranoside) to the growth medium.Optionally this is at a concentration of between 0.1 and 10 mM, 0.1 and5 mM, 0.1 and 2.5 mM, 0.2 and 10 mM, 0.2 and 5 mM, 0.2 and 2.5 mM, 0.4and 10 mM, 1 and 10 mM, 1 and 5 mM, 2.5 and 10 mM, 2.5 and 5 mM, 5 and10 mM. Alternatively the promoter may be induced by a change intemperature or pH.

Host Cells

For recombinant production of the polypeptides of the invention, hostcells can be genetically engineered to incorporate expression systems orportions thereof or polynucleotides of the invention. Introduction of apolynucleotide into the host cell can be effected by methods describedin many standard laboratory manuals, such as Davis, et al., BASICMETHODS IN MOLECULAR BIOLOGY, (1986) and Sambrook, et al., MOLECULARCLONING: A LABORATORY MANUAL, 2nd Ed., Cold Spring Harbor LaboratoryPress, Cold Spring Harbor, N.Y. (1989), such as, calcium phosphatetransfection, DEAE-dextran mediated transfection, transvection,microinjection, cationic lipid-mediated transfection, electroporation,conjugation, transduction, scrape loading, ballistic introduction andinfection.

Representative examples of appropriate hosts include gram negativebacterial cells, such as cells of, E. coli, Acinetobacter,Actinobacillus, Bordetella, Brucella, Campylobacter, Cyanobacteria,Enterobacter, Erwinia, Franciscella, Helicobacter, hemophilus,Klebsiella, Legionella, Moraxella, Neisseria, Pasteurella, Proteus,Pseudomonas, Salmonella, Serratia, Shigella, Treponema, Vibrio,Yersinia. In one embodiment the host cell is an Escherichia coli cell.Alternatively gram positive bacterial cells may also be used. A greatvariety of expression systems can be used to produce the polypeptides ofthe invention. In one embodiment the vector is derived from bacterialplasmids. Generally any system or vector suitable to maintain, propagateor express polynucleotides and/or to express a polypeptide in a host maybe used for expression in this regard. The appropriate DNA sequence maybe inserted into the expression system by any of a variety of well-knownand routine techniques, such as, for example, those set forth inSambrook et al., MOLECULAR CLONING, A LABORATORY MANUAL, (supra).

Immunogenic Compositions and Vaccines

There is further provided an immunogenic composition comprising apolypeptide of the invention and a pharmaceutically acceptableexcipient.

In one embodiment the immunogenic composition further comprises anadjuvant. The choice of a suitable adjuvant to be mixed with bacterialtoxins or conjugates made using the processes of the invention is withinthe knowledge of the person skilled in the art. Suitable adjuvantsinclude an aluminium salt such as aluminium hydroxide gel or aluminumphosphate or alum, but may also be other metal salts such as those ofcalcium, magnesium, iron or zinc, or may be an insoluble suspension ofacylated tyrosine, or acylated sugars, cationically or anionicallyderivatized saccharides, or polyphosphazenes.

In one embodiment the immunogenic composition further comprisesadditional antigens. In one embodiment the additional antigens areantigens derived from a bacterium selected from the group consisting ofS. pneumoniae, H. influenzae, N. meningitidis, E. coli, M. cattarhalis,tetanus, diphtheria, pertussis, S. epidermidis, enterococci, S. aureus,and Pseudomonas aeruginosa. In a further embodiment the immunogeniccomposition of the invention may comprise further antigens from C.difficile for example the S-layer proteins (WO01/73030). Optionally theimmunogenic composition further comprises a saccharide from C.difficile.

There is further provide a vaccine comprising the immunogeniccomposition this vaccine may further comprise a pharmaceuticallyacceptable excipient. In a further aspect of the invention there isprovided a vaccine comprising the immunogenic composition of theinvention and an adjuvant.

The vaccine preparations containing immunogenic compositions of thepresent invention may be used to protect a mammal susceptible to C.difficile infection or treat a mammal with a C. difficile infection, bymeans of administering said vaccine via systemic or mucosal route. Theseadministrations may include injection via the intramuscular,intraperitoneal, intradermal or subcutaneous routes; or via mucosaladministration to the oral/alimentary, respiratory, genitourinarytracts. Although the vaccine of the invention may be administered as asingle dose, components thereof may also be co-administered together atthe same time or at different times (for instance pneumococcalsaccharide conjugates could be administered separately, at the same timeor 1-2 weeks after the administration of the any bacterial proteincomponent of the vaccine for coordination of the immune responses withrespect to each other). In addition to a single route of administration,2 different routes of administration may be used. For example,saccharides or saccharide conjugates may be administered intramuscularly(IM) or intradermally (ID) and bacterial proteins may be administeredintranasally (IN) or intradermally (ID). In addition, the vaccines ofthe invention may be administered IM for priming doses and IN forbooster doses.

The content of toxins in the vaccine will typically be in the range1-250 μg, preferably 5-50 μg, most typically in the range 5-25 μg.Following an initial vaccination, subjects may receive one or severalbooster immunizations adequately spaced. Vaccine preparation isgenerally described in Vaccine Design (“The subunit and adjuvantapproach” (eds Powell M. F. & Newman M. J.) (1995) Plenum Press NewYork). Encapsulation within liposomes is described by Fullerton, U.S.Pat. No. 4,235,877.

In one aspect of the invention is provided a vaccine kit, comprising avial containing an immunogenic composition of the invention, optionallyin lyophilised form, and further comprising a vial containing anadjuvant as described herein. It is envisioned that in this aspect ofthe invention, the adjuvant will be used to reconstitute the lyophilisedimmunogenic composition.

A further aspect of the invention is a method of preventing or treatingC. difficile infection comprising administering to the host animmunoprotective dose of the immunogenic composition or vaccine or kitof the invention. In one embodiment there is provided a method ofpreventing or treating primary and/or recurrence episodes of c.difficile infection comprising administering to the host animmunoprotective dose of the immunogenic composition or vaccine or kitof the invention.

A further aspect of the invention is an immunogenic composition orvaccine or kit of the invention for use in the treatment or preventionof C. difficile disease. In one embodiment there is provided animmunogenic composition or vaccine or kit of the invention for use inthe treatment or prevention of primary and/or recurrence episodes of C.difficile disease.

A further aspect of the invention is use of the immunogenic compositionor vaccine or kit of the invention in the manufacture of a medicamentfor the treatment or prevention of C. difficile disease. In oneembodiment there is provided an immunogenic composition or vaccine orkit of the invention for use in the manufacture of a medicament for thetreatment or prevention of primary and/or recurrence episodes of C.difficile disease.

Around” or “approximately” are defined as within 10% more or less of thegiven figure for the purposes of the invention.

The terms “comprising”, “comprise” and “comprises” herein are intendedby the inventors to be optionally substitutable with the terms“consisting of”, “consist of” and “consists of”, respectively, in everyinstance. The term “comprises” means “includes.” Thus, unless thecontext requires otherwise, the word “comprises,” and variations such as“comprise” and “comprising” will be understood to imply the inclusion ofa stated compound or composition (e.g., nucleic acid, polypeptide,antigen) or step, or group of compounds or steps, but not to theexclusion of any other compounds, composition, steps, or groups thereof.The abbreviation, “e.g.” is derived from the Latin exempli gratia, andis used herein to indicate a non-limiting example. Thus, theabbreviation “e.g.” is synonymous with the term “for example.”

Embodiments herein relating to “vaccine compositions” of the inventionare also applicable to embodiments relating to “immunogeniccompositions” of the invention, and vice versa.

Unless otherwise explained, all technical and scientific terms usedherein have the same meaning as commonly understood by one of ordinaryskill in the art to which this disclosure belongs. Definitions of commonterms in molecular biology can be found in Benjamin Lewin, Genes V,published by Oxford University Press, 1994 (ISBN 0-19-854287-9); Kendrewet al. (eds.), The Encyclopedia of Molecular Biology, published byBlackwell Science Ltd., 1994 (ISBN 0-632-02182-9); and Robert A. Meyers(ed.), Molecular Biology and Biotechnology: a Comprehensive DeskReference, published by VCH Publishers, Inc., 1995 (ISBN 1-56081-569-8).

The singular terms “a,” “an,” and “the” include plural referents unlesscontext clearly indicates otherwise. Similarly, the word “or” isintended to include “and” unless the context clearly indicatesotherwise. The term “plurality” refers to two or more. It is further tobe understood that all base sizes or amino acid sizes, and all molecularweight or molecular mass values, given for nucleic acids or polypeptidesare approximate, and are provided for description. Additionally,numerical limitations given with respect to concentrations or levels ofa substance, such as an antigen, may be approximate.

All references or patent applications cited within this patentspecification are incorporated by reference herein in their entirety.

In order that this invention may be better understood, the followingexamples are set forth. These examples are for purposes of illustrationonly, and are not to be construed as limiting the scope of the inventionin any manner.

EXAMPLES Example 1 Design of Five C. difficile ToxA-ToxB Fusions

Fusion proteins containing fragments of the C-terminal repeating domainsof ToxA and ToxB were designed. These fusions contained a fragment ofthe C-terminal repeating domain of ToxA and a fragment of the C-terminalrepeating domain of ToxB, and a junction between the C-terminal end ofthe ToxA fragment and the N terminal end of the ToxB fragment. Twostrategies were devised, in the first strategy; the fusion was designedsuch that the long solenoid structure was maintained at the junctionbetween the two fragments. In the second strategy, the two fragments ofthe fusions are separated by a linker to allow their independent correctfolding.

The C-terminal part of ToxA and B is composed of repeated sequences:short repeats (SR) and long repeats (LR) (PNAS 2005 vol 102:18373-18378).

The partial known 3D structure for the C-terminal domain of ToxA (PNAS2005 Greco et al., vol 102: 18373-18378; Nature Structural & Molecularbiology 2006 vol 13(5): 460-461; PDB codes: 2F6E, 2G7C and 2QJ6).

The inventors predicted that there are two kinds of importantinteractions between residues of the C-terminal part of ToxA and ToxB.The first interaction is occurring between residues contained in a LRand its preceding SR and is important to maintain the solenoid-likestructure. The second type of interaction occurs between residuescontained in a LR and the following SR and this interaction is mediatingthe carbohydrate-binding function of the toxin.

A new “structural-functional” repeat SR-LR-SR was defined. The structureof this repeat was maintained intact in our designed fusions.

FIG. 2 represents the C-terminal domains of ToxA and ToxB and thedefined “SR-LR-SR” box.

The positions of the short (SR) and long repeats (LR) of ToxA and ToxBrepeats are presented in table 1.

A list of the “SR-LR-SR” boxes contained in the C-terminal domain ofToxA and ToxB is presented in Table 2.

TABLE 2 Start End Name position position ToxA_1 1874 1944 ToxA_2 20082078 ToxA_3 2142 2212 ToxA_4 2254 2326 ToxA_5 2390 2460 ToxA_6 2503 2573ToxA_7 2595 2664 ToxB_1 1877 1946 ToxB_2 2008 2078 ToxB_3 2140 2212ToxB_4 2274 2343

Finally, the number of SRs between two LRs will be maintained in thedesigned fusions to keep the long solenoid-like structure.

Before the design of junctions for the fusions, two working hypotheseswere defined: first hypothesis, the shorter the fusions, the better theprobability for the fusions to be stably over expressed; secondhypothesis, according to the concept of “SR-LR-SR” boxes, the startposition has to be chosen in order to ensure a correct folding of thefirst SR of this previously defined SR-LR-SR box. Thus the fusions startat the beginning of the SR that precedes the SR-LR-SR box. Using thesetwo hypothesis, three start positions were analysed: residue 2370, 2234and 2121 of ToxA.

The start position 2370 was excluded. The start position 2234 was alsoexcluded because one of the residues involved in interactions importantfor the protein structural stability is not conserved. So, it wasdecided that all the designed fusion will begin at residue 2121 of ToxA.

All fusions will end at the last residue of ToxB.

Four fusions (F1-4) were designed in order to maintain the entire fusionin a long solenoid-like structure between the two fusion fragments.

The fusions 1 (F1) and 2 (F2) were designed using the same hypothesis.All SR protein sequences of ToxA and ToxB had been compared using amultiple alignment software (ClustalW—Thompson J D et al. (1994) NucleicAcids Res., 22, 4673-4680). The more similar sequences were the third SRVIII of ToxA and the third SR II of ToxB and third SR III of ToxB. Inorder to make a choice between these two SR of ToxB, a structuralhomology modelling (using the SwissModel interface—Arnold K et al.(2006) Bioinformatics, 22, 195-201) was performed on the C-terminal partof ToxB using the known 3D structure of partial ToxA C-terminal domain(PDB code: 2QJ6). Using the third SR VIII of ToxA, the best localstructural superposition (performed using SwissPDBViewer—Guex N et al.(1997), Electrophoresis 18, 2714-2723) was obtained with the third SR IIof ToxB. So, two junctions were designed: the first one is between thethird SR VIII of ToxA and the fourth SR II of ToxB (F1) and the secondone is between the second SR VIII of ToxA and the third SR II of ToxB(F2). These junctions are presented in FIGS. 3 and 4 respectively.

To design the fusion 3 (F3), a global structural superposition wasperformed between both the known structure of the partial C-terminaldomain of ToxA and the predicted structure of C-terminal domain of ToxB(using SwissModel and SwissPDBViewer softwares). The best superpositionwas found between LR VII of ToxA and LR II of ToxB. So, it was decidedto make a junction in this similar LR. The junction was performedfirstly in a region where the sequence is conserved between ToxA andToxB, after that in order to keep in the ToxA part of the fusion, theresidues in interaction with the preceding SR and lastly, in order tokeep in the ToxB part, the residues in interaction with the followingSR. This junction is shown in FIG. 5.

For the design of fusion 4 (F4), the C-terminal domain of ToxB wasdivided in 4 fragments and a more precise homology modelling(SwissModel) was performed on them. The split was realised in order tokeep intact the “SR-LR-SR” boxes (each domain finishes at the end of theSR that follows a LR). A structural superposition between the predictedstructures of these fragment and the known 3D structure of ToxA was madeand the best structural surperposition was obtained for the third SR ofToxB (SR I) and the last SR of ToxA (third SR VIII). So, the junctionwas done between the second SR VIII of ToxA and the third SR I of ToxB.This design is presented in FIG. 6.

The last fusion (F5) was designed in order to allow an independentcorrect folding of the two fragments of the fusion. The linker was addedbetween the last residue of the ToxA protein sequence and the beginningof the fourth SR II of ToxB (always taking into account the importanceof an intact “SR-LR-SR” box). Only one exogenous residue (Glycine) wasadded as linker and located between two existing Glycines. Thus, thelinker can also be described as composed of 3 Glycines surrounding byknown (for ToxA) and predicted (for ToxB) beta-strand. This last designis shown in FIG. 7.

Example 2 Cloning Expression and Purification of the Fusion Proteins

Expression Plasmid and Recombinant Strain

Genes encoding the fusion proteins of partial C-terminal domains of ToxAand ToxB (SEQ ID NO:3, 4, 5, 6 and 7) and a His tag were cloned into thepET24b(+) expression vector (Novagen) using the NdeI/XhoI restrictionsites using standard procedures. The final construct was generated bythe transformation of E. coli strain BLR (DE3) with the recombinantexpression vector according to standard method with CaCl2-treated cells(Hanahan D. <<Plasmid transformation by Simanis.>> In Glover, D. M.(Ed), DNA cloning. IRL Press London. (1985): p. 109-135.).

Host Strain:

BLR(DE3). BLR is a recA derivative of BL21. Strains having thedesignation (DE3) are lysogenic for a λ prophage that contains an IPTGinducible T7 RNA polymerase. λ DE3 lysogens are designed for proteinexpression from pET vectors This strain is also deficient in the Ion andompT proteases.

Genotype: E. coli BLR::DE3 strain, F⁻ ompT hsdS_(B)(r_(B) ⁻m_(B) ⁻) galdcm (DE3) Δ(srl-recA)306::Tn10 (Tet^(R))

Expression of the Recombinant Proteins:

An E. coli transformant was stripped from agar plate and used toinoculate 200 ml of LBT broth±1% (w/v) glucose+kanamycin (50 μg/ml) toobtain O.D. 600 nm between 0.1-0.2. Cultures were incubated overnight at37° C., 250 RPM.

This overnight culture was diluted to 1:20 in 500 ml of LBT mediumcontaining kanamycin (50 μg/ml) and grown at 37° C. at a stirring speedof 250 rpm until O.D. 620 reached 0.5/0.6.

At O.D. 600 nm around 0.6, the culture was cooled down before inducingthe expression of the recombinant protein by addition of 1 mM isopropylβ-D-1-thiogalactopyranoside (IPTG; EMD Chemicals Inc., catalogue number:5815) and incubated overnight at 23° C., 250 RPM.

After overnight induction (around 16 hours), O.D._(600nm) was evaluatedafter induction and culture was centrifuged at 14 000 RPM for 15 minutesand pellets were frozen at −20° C. separately.

Purification:

The bacterial pellet was resuspended in 20 mM bicine buffer (pH 8.0)containing 500 mM NaCl and a mixture of protease inhibitor (Complete,Roche). Bacteria were lysed using a French Press system 20 000 PSI.Soluble (supernatant) and insoluble (pellet) components were separatedby centrifugation for example at 20 000 g for 30 min at 4° C.

The 6-His tagged-protein was purified under native conditions on IMAC.The soluble components were loaded on a GE column (15 ml for example)(Ni loaded) preequilibrated with the same buffer used to bacterialresuspension. After loading on the column, the column was washed withthe same buffer. Elution was performed using a 20 mM bicine buffer (pH8.0) containing 500 mM NaCl and different concentrations of imidazole(5-600 mM). After gel analysis, more pure fractions were selected,concentrated and loaded on SEC chromatography for further purificationstep.

Fractions containing the fusion proteins were selected on the basis ofpurity by SDS-PAGE and dialyzed against bicine buffer (20 mM Bicine, 150mM NaCl, with or without 5 mM EDTA pH8.0), Protein concentration wasdetermined using DC Protein Assay of BioRad. Proteins were thus pooled,sterile-filtered on 0.22 μm, stored at −80° C.

Alternatively, IMAC purification was preceded by a DEAE purificationstep using 2 mM bicine buffer (pH 8.0) for loading and washing, andeluted using a gradient with the same buffer but with 1M NaCl added.

Example 3 Cloning Expression and Purification of the Separate C.difficile Tox A and Tox B Fragments

Expression Plasmid and Recombinant Strain.

Genes encoding the protein fragments of ToxA and ToxB (SEQ ID NO:8 andSEQ ID NO:9) and a His tag were cloned into the pET24b(+) expressionvector (Novagen) using the NdeI/XhoI restriction sites using standardprocedures. The final construct was generated by the transformation ofE. coli strain BLR (DE3) with the recombinant expression vectoraccording to standard method with CaCl2-treated cells (Hanahan D.<<Plasmid transformation by Simanis.>> In Glover, D. M. (Ed), DNAcloning. IRL Press London. (1985): p. 109-135.).

Host Strain:

BLR(DE3). BLR is a recA derivative of BL21. Strains having thedesignation (DE3) are lysogenic for a λ prophage that contains an IPTGinducible T7 RNA polymerase. λ DE3 lysogens are designed for proteinexpression from pET vectors This strain is also deficient in the Ion andompT proteases.

Genotype: E. coli BLR::DE3 strain, F⁻ ompT hsdS_(B)(r_(B) ⁻ m_(e) ⁻) galdcm (DE3) Δ(srl-recA)306::Tn10 (Tet^(R))

Expression of the Recombinant Proteins:

A E. coli transformant was stripped from agar plate and used toinoculate 200 ml of LBT broth±1% (w/v) glucose+kanamycin (50 μg/ml) toobtain O.D._(600nm) between 0.1-0.2. Cultures were incubated overnightat 37° C., 250 RPM.

This overnight culture was diluted to 1:20 in 500 ml of LBT mediumcontaining kanamycin (50 μg/ml) and grown at 37° C. at a stirring speedof 250 rpm until O.D.₆₂₀ reached 0.5/0.6.

At an O.D. at 600 nm of around 0.6, the culture was cooled down beforeinducing the expression of the recombinant protein by addition of 1 mMisopropyl β-D-1-thiogalactopyranoside (IPTG; EMD Chemicals Inc.,catalogue number: 5815) and incubated overnight at 23° C., 250 RPM.

After the overnight induction (around 16 hours), O.D. at 600 nm wasevaluated after induction and culture was centrifuged at 14 000 RPM for15 minutes and pellets were frozen at −20° C. separately.

Purification:

The bacterial pellet was resuspended in 20 mM bicine buffer (pH 8.0)containing 500 mM NaCl supplemented by a mixture of protease inhibitor(Complete without EDTA, Roche cat 11873580001) and benzonase. (Roche cat1.01695.0001). Bacteria were lysed using a French Press system 2×20 000PSI. Soluble (supernatant) and insoluble (pellet) components wereseparated by centrifugation at 34 000 g or 48 000 g for 25-30 min at 4°C. Supernatant was harvested and filtrated on 0.22 μm filter.

The 6-His tagged-protein was purified under native conditions on IMAC.The soluble components were loaded on a GE column (for example 15 ml)(Ni loaded) pre-equilibrated with the same buffer used to bacterialresuspension. After loading, the column was washed with the same buffer.

For ToxA:

Elution was performed using a 20 mM bicine buffer (pH 8.0) containing500 mM NaCl and different concentrations of imidazole (5-100 mM). Aftergel analysis, more pure fractions were selected, concentrated and loadedon SEC chromatography (SUPERDEX™ 75) for further purification step inthe same buffer without imidazole.

For ToxB:

A second wash was performed with 20 mM bicine buffer (pH 8.0) containing500 mM NaCl and 0.5% deoxycholate or same buffer with 150 mM NaCl.Elution was performed using a 20 mM bicine buffer (pH 8.0) containing500 mM NaCl and different concentrations of imidazole (10-500 mM). Aftergel analysis, more pure fractions were selected, supplemented with 5 mMEDTA and loaded on SEC chromatography (SUPERDEX™ 200) for furtherpurification step in same buffer with 5 mM EDTA.

Fractions containing ToxA or ToxB fragments were selected on the basisof purity by SDS-PAGE and dialyzed against bicine buffer (20 mM Bicine,150 mM NaCl, pH8.0), protein concentration was determined using RCDCProtein Assay of BioRad. Proteins were thus pooled, sterile-filtered on0.22 μm, stored at −80° C.

Example 4 Molecular Weight Evaluation of the Five C. difficile ToxA-ToxBFusions

Analytical ultracentrifugation is used to determine the homogeneity andsize distribution in solution of the different species within a proteinsample by measuring the rate at which molecules move in response to acentrifugal force. This is based on the calculation of the coefficientsof sedimentation of the different species that are obtained bysedimentation velocity experiment, which depend on their molecular shapeand mass.

-   1. Protein samples are spun in a Beckman-Coulter PROTEOMELAB™ XL-1    analytical ultracentrifuge at 42 000 RPM after the AN-60Ti rotor had    been equilibrated to 15° C.-   a. F1 fusion protein, 500 μg/ml, 20 mM Bicine, 150 mM NaCl, pH8.0-   b. F2 fusion protein, 500 μg/ml, 20 mM Bicine, 150 mM NaCl, pH8.0-   c. F3 fusion protein, 500 μg/ml, 20 mM Bicine, 150 mM NaCl, pH8.0-   d. F4 fusion protein, 500 μg/ml, 20 mM Bicine, 150 mM NaCl, pH8.0-   e. F5 fusion protein, 500 μg/ml, 20 mM Bicine, 150 mM NaCl, pH8.0-   2. For data collection, 160 scans were recorded at 280 nm every 5    minutes.-   3. Data analysis was performed using the program SEDFIT for    determination of the C(S) distribution. Determination of the partial    specific volume of the proteins was performed with the SEDNTERP    software from their amino acid sequence. SEDNTERP was also used to    determine the viscosity and the density of the buffer.-   4. The molecular weight of the different species was determined from    the C(S) distribution plot (concentration vs sedimentation    coefficient), considering that it's a better representation of the    raw data than the C(M) distribution (concentration vs molecular    weight) to characterize the size distribution of a mixture.

FIG. 8 describes the distribution of the ToxA-ToxB fusions as determinedby sedimentation velocity analytical ultracentrifugation.

The molecular weight of the major species detected from the C(S)distribution of all five ToxA-ToxB fusion proteins corresponds to theirmonomeric form. The best fit frictional ratios determined for the fivefusions are all between 2 and 2.2. This may indicate that the proteinsare present in solution as an elongated form, which would be consistentwith the protein structure.

Example 5 Evaluation of Secondary and Tertiary Structures of C.difficile ToxA-ToxB Fusions by Circular Dichroism and FluorescenceSpectroscopy

Circular dichroism is used to determine the secondary structurecomposition of a protein by measuring the difference in the absorptionof left-handed polarized light versus right-handed polarized light whichis due to structural asymmetry. The shape and the magnitude of the CDspectra in the far-UV region (190-250 nm) are different whether aprotein exhibits a beta-sheet, alpha-helix or random coil structure. Therelative abundance of each secondary structure type in a given proteinsample can be calculated by comparison to reference spectra.

The tertiary structure of a protein sample can be assessed by theevaluation of the immobilisation of the aromatic amino acids. Theobservation of a CD signal in the near-UV region (250-50 nm) may beattributable to the polarization of phenylalanine, tyrosine andtryptophane residues and is a good indication that the protein is foldedinto a well defined structure.

The following protocol was used:

-   1. Far UV spectra are measured using an optical path of 0.01 cm from    178 to 250 nm, with a 1 nm resolution and bandwidth on a Jasco J-720    spectropolarimeter. Temperature of the cell is maintained at 23° C.    by a Peltier thermostated RTE-111 cell block. A nitrogen flow of 10    L/min is maintained during the measurements.-   2. Near-UV spectra are measured using an optical path of 0.01 cm    from 250 to 300 nm, with a 1 nm resolution and bandwidth on a Jasco    J-720 spectropolarimeter. Temperature of the cell is maintained at    23° C. by a Peltier thermostated RTE-111 cell block. A nitrogen flow    of 6 L/min is maintained during the measurements.

The observation of the far-UV spectra (FIG. 9) for all five ToxA-ToxBfusion proteins suggests a weak content of alpha helix structures and ahigh content of beta sheet structures. Also, all proteins exhibited amaximum at 230 nm, which is unusual for soluble globular proteins. Thisparticularity has been well characterized in the literature and isassociated with a small group of proteins known for their absence ofalpha helix and their high content in beta sheet and aromatic aminoacids (Zsila, Analytical Biochemistry, 391(2009) 154-156). Thoseparticularities are coherent with the structure that is expected for theToxA-ToxB fusion proteins. Crystal structures of 13 proteins exhibitingthe characteristic CD spectra with a positive signal at 230 nm werecompared (Protein Data Bank). The average secondary structure content ofthose proteins is 42% beta sheet±9% and 7% alpha helix±6%. This stronglyindicates that the spectral signature of the ToxA-ToxB fusion proteinsis diagnostic of a high beta sheet and low alpha helix containingprotein.

The observation of the shape of the near-UV spectra (FIG. 10) for allfive fusion proteins indicates that at least some of the aromatic aminoacids are immobilised, which is a strong indication of a compact andspecific tertiary structure. Moreover, the treatment of the protein witha denaturing concentration of urea caused the disappearance of thenear-UV signal, which is an additional indication that thischaracteristic spectra was due to protein folding.

Example 6 Immunisation of Mice with Tox A or Tox B Fragments andToxA-ToxB Fusions

Balb/C mice were immunized with the constructs described in examples 2and 3.

Mice Immunization

Groups of 15 female Balb/c mice were immunized IM at days 0, 14 and 28with 3 μg or 10 μg of the separate fragments of toxA and toxB (seeexample 2) as well as with ToxA-ToxB fusions proteins (see example 3)adjuvanted with AS03B. A control group of 10 mice was vaccinated withAS03B alone.

Anti-ToxA and anti-ToxB ELISA titers were determined in individual seracollected at day 42 (post III).

Hemagglutination inhibition titers were determined in pooled Post IIIsera.

Anti-ToxA and Anti-ToxB ELISA Response: Protocol

Samples of the toxA or toxB fragments were coated at 1 μg/ml inphosphate buffered saline (PBS) on high-binding microtitre plates (NuncMAXISORP™), overnight at 4° C. The plates were blocked with PBS-BSA 1%for 30 min at RT with agitation. The mice anti-sera are prediluted 1/500in PBS-BSA 0.2%-TWEEN™ 0.05%. and then, further twofold dilutions weremade in microplates and incubated at RT for 30 min with agitation. Afterwashing, bound murine antibody was detected using JacksonImmunoLaboratories Inc. peroxidase-conjugated affiniPure Goat Anti-MouseIgG (H+L) (ref: 115-035-003) diluted 1:5000 in PBS-BSA0.2%-tween 0.05%.The detection antibodies were incubated for 30 min. at room temperature(RT) with agitation. The color was developed using 4 mgO-phenylenediamine (OPD)+5 μl H₂O₂ per 10 ml pH 4.5 0.1M citrate bufferfor 15 minutes in the dark at room temperature. The reaction was stoppedwith 50 μl HCl, and the optical density (OD) was read at 490 nm relativeto 620 nm.

The level of anti-ToxA or anti-ToxB antibodies present in the sera wasexpressed in mid-point titers. A GMT was calculated for the 15 samplesin each treatment group (10 for the control group).

Hemaqqlutination Inhibition Assay: Protocol

Serial twofold dilutions of mice pooled antisera (25 μl) were performedin phosphate buffered saline (PBS) in 96-well U-bottom microplates.

25 μl of native Toxin A (0.2 μg/well) were then added and the plateswere incubated at room temperature for 30 minutes.

After incubation, 50 μl of purified rabbit erythrocytes diluted at 2%were added to each well. The plates were incubated at 37° C. for 2hours.

Plates were analysed visually, with hemagglutination presenting asdiffuse red cells in the well and the inhibition of hemagglutinationobserved as a red point settled in the well.

The inhibition titers were defined as the reciprocal of the highestdilution of the serum inhibiting hemagglutination.

Cytotoxicity Assay

IMR90 fibroblast cells were cultured at 37° C. with 5% CO₂, in EMEM+10%fetal bovine serum+1% glutamine+1% antibiotics(penicillin-streptomycin-amphotericin) and were seeded in 96-well tissueculture plates at a density of 5·10⁴ cells/well.

After 24 h, the cell media was removed from the wells.

Serial twofold dilutions of mice pooled antisera (50 μl) were performedin cell media.

50 μl of native Toxin B (0.5 ng/ml) is then added and the platesincubated at 37° C. with 5% CO2 for 24 hours.

Cells were observed after 24 hours, and the proportion of rounded cellswas determined.

The inhibition titers were defined as the reciprocal of the highestdilution of the serum inhibiting 50% cell rounding.

Results:

Elisa results, using Tox A antibodies are described in FIG. 11. Anti-ToxA antibodies were induced after immunization with the ToxA alone butalso with each of the 5 fusions.

The functional properties of these antibodies were tested in thehemagglutination assay. This assay is only adapted for Tox A evaluationas no hemagglutination is observed with ToxB.

Haemagglutination inhibition titres are described in FIG. 12.Haemaglutination inhibition was observed with the anti-Tox A fragmentsera or sera directed against each of the ToxA-ToxB fusions.

An ELISA using ToxB antibodies was also performed; the results of thisare illustrated in FIG. 13. Anti-Tox B antibodies were induced afterimmunization with the ToxB fragment alone but also with the F2, F3 andF4 fusions.

Cytotoxicity inhibition titres are described in FIG. 14. Inhibitiontiters obtained using sera from mice immunised with the ToxB fragment orthe ToxA-ToxB fusions were greater than that obtained using controlsera.

Example 7 Design, Cloning, Expression and Purification of 4 FurtherFusion Proteins

Four further fusion proteins were designed using the design principlesdescribed in example 1, these were named F54 Gly (SEQ ID NO:11), F54 New(SEQ ID NO:13), F5 ToxB (SEQ ID NO:15) and F52 New (SEQ ID NO:17).

These fusion proteins were expressed according to the proceduredescribed in example 2.

Example 8 Molecular Weight Evaluation of the C. difficile ToxA-ToxBFusions Described in SEQ ID NO:11, SEQ ID NO:13, SEQ ID NO:15, and SEQID NO:17

The molecular weight of the fusions described in SEQ ID NO:11, SEQ IDNO:13, SEQ ID NO:15, and SEQ ID NO:17 were determined as described inexample 4.

FIG. 15 describes the distribution of these four further fusion proteinsas determined by sedimentation velocity analytical ultracentifugation.

The molecular weight of the main species determined from the C(S)distribution of all four protein fusions described in SEQ ID NO:11, SEQID NO:13, SEQ ID NO:15, and SEQ ID NO:17 corresponds to their monomericform and all proteins exhibit sedimentation properties similar to F1 toF5 fusions.

Example 9 Evaluation of Secondary and Tertiary Structures of C.difficile ToxA-ToxB Fusions Described in SEQ ID NO:11, SEQ ID NO:13, SEQID NO:15, and SEQ ID NO:17

The secondary and tertiary structures of the fusions described in SEQ IDNO:11, SEQ ID NO:13, SEQ ID NO:15, and SEQ ID NO:17 were assessedaccording to the method described in example 5. The far UV CD for thesefusion proteins can be found in FIG. 16, and the near UV spectra forthese fusions can be found in FIG. 17.

Analysis of the near and far UV CD spectra of the proteins described inSEQ ID NO:11, SEQ ID NO:13, SEQ ID NO:15, and SEQ ID NO:17 shows thatall four have the same high beta sheet structure than F1 to F5 fusions.In addition, observation of the near UV spectra show no significantdifference in the position of the aromatic amino acids in the tertiarystructure compared to F1 to F5 fusions.

Example 10 Immunisation of Mice with Tox A-Tox B Fusions

Balb/c mice were immunised with the four fusion protein constructs F54Gly (SEQ ID NO:11), F54 New (SEQ ID NO:13), F5 ToxB (SEQ ID NO:15) andF52 New (SEQ ID NO:17) as described in example 6.

An ELISA was carried out using the anti-ToxA and anti-ToxB ELISAresponse:protocol described in example 6 except here the samples of thetoxA or toxB fragments were coated at 2 μg/ml in phosphate bufferedsaline on high-binding microtitre plates. A hemagglutination inhibitionassay was performed as described in example 6. A toxB cytotoxicity assaywas performed as described in example 6. A further toxA cytotoxicityassay was performed as described below.

ToxA Cytotoxicity Assay

HT29 cells were cultured at 37° C. with 5% CO₂ in DMEM+10% fetal bovineserum+1% glutamine+1% antibiotics (penicillin-streptomycin-amphotericin)and were seeded in 96-well tissue culture plates at a density of 5·10⁴cells/well.

After 24 h, the cell media was removed from the wells.

Serial twofold dilutions of mice pooled antisera (50 μl) were performedin cell media.

50 μl of native Toxin B (0.15 ng/ml) is then added and the platesincubated at 37° C. with 5% CO₂ for 48 hours.

Cells were observed after 48 hours and the proportion of rounded cellswere determined.

The results of the anti-toxA ELISA, anti-toxB Elisa, Haemagglutinationinhibition and cytotoxicity assays are described in FIGS. 18, 19, 20, 21and 22 respectively.

I claim:
 1. A fusion polypeptide comprising SEQ ID NO:5.
 2. Animmunogenic composition comprising the fusion polypeptide of claim 1 anda pharmaceutically acceptable excipient.
 3. The immunogenic compositionof claim 2 further comprising an adjuvant.